Healthcare Provider Details

I. General information

NPI: 1326872185
Provider Name (Legal Business Name): NICHOLAS HEBERT DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CENTRAL AVE
DOVER NH
03820-6431
US

IV. Provider business mailing address

400 CENTRAL AVE
DOVER NH
03820-6431
US

V. Phone/Fax

Practice location:
  • Phone: 603-749-6053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number05314
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: